Submit this form if you are or were a caregiver or close family member of someone with kidney disease. Please give as much information as you are comfortable with.

Read other caregiver - family member stories

Name *
The city and state where you live.
Tell us how you identify yourself as an individual and what your life is all about. We want to get to know YOU. Anything about your career, hobbies, passions, family etc that you are comfortable sharing and would help us know you.
Please explain when the diagnosis of kidney disease/failure was and any details that would help us understand the situation.
Please give as much detail as you can and are comfortable with so we fully understand your situation.
Mention any life adjustments that had to be made. Please don't feel guilty about being honest. It's important to share this side of the story so others know how to support care givers in the future.
Mention any online resources or organizations if applicable.
In not just say NO.
Do we have permission to share your story on our social media and blog? *
Would you be willing to email us a picture of yourself for the blog? *
If YES, please email photo(s) to
Would you like to be signed up for the Get Loud For Kidneys Newsletter? *
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